Report of Illness

**Please note: You must be following standard company policy and calling in to the restaurant 651-222-5670 and  by submitting this form at least 3 hours prior to your scheduled shift.  We need to opportunity to cover the shift and have the PTO request approved. Thank you.**

Name *
Name
Date *
Date
(Please describe your symptoms of illness)

All "Report of Illness" submissions will be sent to management and evaluated for approval.  
Once approval is granted the hours will be submitted to payroll for benefits.  
Your submission will be logged in our company "sick log" and tracked for health & HR purposes.  

We truly hope you feel better and are able to return to work soon.